Hanoi – Ms. Mo, 31 years old, has had type 1 diabetes for over 10 years. During her pregnancy, she followed an excessively restrictive diet, leading to exhaustion.
On February 18th, Dr. Le Ba Ngoc, Head of the General Internal Medicine Department at Tam Anh General Hospital in Hanoi, stated that Ms. Mo, 5 weeks pregnant, was in a weakened state. Her BMI was 18 – indicating malnutrition – and her fasting blood sugar was above 13 mmol/l (the normal range is 5.3 mmol/l or below). The pregnant woman needed to change her diet to increase nutrition to ensure fetal development while still achieving blood sugar control. "This is a difficult problem for both the doctor and the patient," Dr. Ngoc said.
Dr. Ngoc collaborated with Dr. Vu Thi Thanh, Head of the Nutrition Department, to develop a treatment plan for the patient, including a nutritional menu, medication, and exercise regimen. As the pregnancy progressed, blood sugar levels fluctuated constantly. Every day, Ms. Mo had to test her blood sugar six times before and after meals to adjust her medication dosage.
According to Dr. Ngoc, capillary blood glucose testing by pricking the fingertip is not feasible because pregnant women need to monitor their blood glucose daily. Dr. Ngoc advises pregnant women to use a continuous glucose monitoring device, which displays the results directly on the machine, eliminating the need for finger pricks. This technology is more effective than capillary blood glucose testing.
Doctor Ngoc advises patients on their health condition. Photo: Provided by the hospital.
After three follow-up appointments, Ms. Mo adhered to her diet, and her weight and blood sugar levels finally met the standards. She is currently 36 weeks pregnant, has gained 13 kg, her blood sugar is stable, and the fetus weighs nearly 2.5 kg.
For people with diabetes, improper treatment or inadequate nutrition can lead to obesity or wasting, resulting in unstable blood sugar levels. Patients need to control their blood sugar before, during, and after pregnancy.
Dr. Ngoc advises pregnant women with gestational diabetes to seek advice on a blood sugar control plan during labor and after delivery. Newborns should be fed as soon as possible after birth to avoid the risk of hypoglycemia.
In the postpartum period, insulin doses need to be reduced compared to during pregnancy to prevent hypoglycemia due to overdose. Postpartum women with type 1 diabetes should continue insulin injections, monitoring blood glucose levels to adjust the dosage. Insulin injections do not affect breastfeeding; however, a suitable diet is necessary to ensure the quality of breast milk for the baby while also helping to better control blood glucose levels.
Thanh Ba
* The patient's name has been changed.
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